Nurse HEDIS Reviewer

2 weeks ago

Arizona City, United States NTT DATA Full time

NTT DATA Services currently seeks a Nurse HEDIS Reviewer to join our team. This is a remote role but must be open to working AZ hours and be a licensed RN or LPN in the state of AZ. Position requires advanced degree and licensing. BSN preferred

Licensed RN (preferred) or LPN with 3 years nursing experience (Note: license must be good in Arizona state)

HEDIS medical record reviewer for the HEDIS MY2024 Audit. Data will be retrieved from medical records obtained through a variety of methods. Position requires flexibility and the ability to work under pressure to meet hard deadlines. Qualified candidates will possess a professional demeanor and have a strong work ethic, be self-motivated, a conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy. Ideal candidates will have 3+ years of HEDIS record abstraction experience, proven organizational and time management skills, experience in a work-from-home scenario, and excellent verbal communication skills - clear, concise, and professional. Must be computer savvy with working knowledge of Microsoft Excel, Outlook, and Adobe preferred. Candidate must be able to commit to duration of the project.

Role Responsibilities -Review, abstract and data enter all medical record data obtained via paper, electronic, CD, fax or mail -Name and file medical record documents electronically, maintaining member PHI and PII -Fax medical record requests to provider offices if requested -Provide patient lists to provider offices -Accurately enter data into Electronic Medical Record Review abstraction tool -Communicate daily with Mercy Care support staff to review any changes in daily expectations -Perform outreach calls as needed to provider offices to obtain medical records

Knowledge of MRR process is strongly preferred, especially HEDIS specific audit experience -Experience with a variety of EMR systems strongly preferred -Experience working from home and setting up home office -Experience reading and interpreting medical records, including handwritten records

Required Skills/Experience What are the required skills for this role? (3-5 at the most). Points to emphasize

  • 3+ years HEDIS specific audit experience.
  • 3 years experience with a variety of EMR systems
  • 3+ years experience working from home and setting up home office
  • 3+ years experience reading and interpreting medical records, including handwritten records
Preferences - Knowledge of MRR process is strongly preferred

Education: Licensed RN (preferred) or LPN with 3 years nursing experience (Note: license must be good in Arizona state)

Hours: Mon - Fri; 7:30 - 4 AZ time (MST)

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $40.00. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

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